Exhibit_G_-_Monthly_CCSD_Community_Action_Inquire_Tracking_Sheet.xlsx
XLSX spreadsheet 18 KB Posted
- Attached to
- Master Agreement AZ|CTR075477
- Contract number
- CTR075477
- Issued by
- Arizona
About this file
The document is an Exhibit G form from the Arizona Department of Economic Security (DES), specifically a Community Action Inquiry Tracking Sheet designed to monitor and record community service inquiries and requests. The form appears to be an administrative tracking mechanism for documenting service interactions across different communication channels including in-person, phone, email, and agency portal.
The tracking sheet is structured to capture details about service requests in categories such as housing, utility assistance, case management, and other supplemental services like food boxes or gas cards. The document provides a systematic method for recording inquiry types, outcomes (including denials and withdrawals), and the various channels through which community members seek assistance. While the specific monetary values are not detailed in this document, it serves as a critical administrative tool for monitoring and reporting community action service interactions for the Arizona DES CCSD (likely Child and Community Services Division) program.
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Text version
SERVICES REQUESTED SHEET
| Exhibit G |
| Arizona Department of Economic Security |
| CCSD COMMUNITY ACTION INQUIRY TRACKING SHEET | |||||||||
| DATE | IN PERSON | PHONE | HOUSING | UTILITY | CASE MGMENT | OTHER | Denied | Withdrawn |
DCAD COMMUNITY ACTION INQUIRY TRACKING SHEET
SERVICES REQUESTED SHEET (rev.
| Exhibit G |
| Arizona Department of Economic Security |
CCSD COMMUNITY ACTION INQUIRY TRACKING SHEET
Instructions: List the number of households inquiries.
| Agency Name: |
| Month/Year: |
| INQUIRY | TYPE | OUTCOME | |||||||
| IN PERSON | PHONE | AGENCY PORTAL | HOUSING | UTILITY | CASE MANAGEMENT | OTHER | |||
| (i.e., food boxes, gas card, etc.) | DENIAL | WITHDRAWN |
DCAD COMMUNITY ACTION INQUIRY TRACKING SHEET
File details come from the government source that posted it. Updated .